0
Specialty Update   |    
What's New in Pediatric Orthopaedics
Young-Jo Kim, MD, PhD1; Kenneth J. Noonan, MD2
1 Children's Hospital-Boston, 300 Longwood Avenue, Hunnewell 225, Boston, MA 02115. E-mail address: young-jo.kim@childrens.harvard.edu
2 K4/732 Clinical Science Center, Department of Orthopaedics and Rehabilitation, University of Wisconsin Hospital and Clinics, 600 Highland Avenue, Madison, WI 53792. E-mail address: noonan@orthorehab.wisc.edu
View Disclosures and Other Information
Specialty Update has been developed in collaboration with the Council of Musculoskeletal Specialty Societies (COMSS) of the American Academy of Orthopaedic Surgeons.
Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. One or more of the authors, or a member of his or her immediate family, received, in any one year, payments or other benefits in excess of $10,000 or a commitment or agreement to provide such benefits from a commercial entity (Biomet).

The Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2009 Mar 01;91(3):743-751. doi: 10.2106/JBJS.H.01689
5 Recommendations (Recommend) | 3 Comments | Saved by 3 Users Save Case

Extract

The epidemiology, treatment, and outcome assessment of neonatal brachial plexus palsy continue to be refined. Foad et al.1 analyzed the Kids' Inpatient Database from 1997, 2000, and 2003 to determine the incidence of neonatal brachial plexus palsy in the United States and additionally to determine the risk factors associated with brachial plexus palsy. In the United States, the incidence was at least 1.51 ± 0.02 cases per 1000 live births, but it decreased over the study period. The identified risk factors were shoulder dystocia (100 times increased risk), exceptionally large birth weight (4.5 kg) (fourteen times increased risk), and forceps delivery (nine times increased risk). On the other hand, twin or multiple births and cesarean section delivery appeared to have a protective effect. There appeared to be other unknown factors that influenced the incidence of brachial plexus palsy as only 46% of all children with this condition had one or more of these risk factors. In fact, 56% of brachial plexus palsies were not associated with a difficult delivery. Finally, the only reliable predictor of shoulder dystocia was a previous episode of shoulder dystocia in the mother.
Figures in this Article

    First Page Preview

    View Large
    />
    First page PDF preview
    Sign In to Your Personal ProfileSign In To Access Full Content
    Not a Subscriber?
    Get online access for 30 days for $35
    New to JBJS?
    Sign up for a full subscription to both the print and online editions
    Register for a FREE limited account to get full access to all CME activities, to comment on public articles, or to sign up for alerts.
    Register for a FREE limited account to get full access to all CME activities
    Have a subscription to the print edition?
    Current subscribers to The Journal of Bone & Joint Surgery in either the print or quarterly DVD formats receive free online access to JBJS.org.
    Forgot your password?
    Enter your username and email address. We'll send you a reminder to the email address on record.

     
    Forgot your username or need assistance? Please contact customer service at subs@jbjs.org. If your access is provided
    by your institution, please contact you librarian or administrator for username and password information. Institutional
    administrators, to reset your institution's master username or password, please contact subs@jbjs.org

    References

    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
    CME Activities Associated with This Article
    Submit a Comment
    Please read the other comments before you post yours. Contributors must reveal any conflict of interest.
    Comments are moderated and will appear on the site at the discretion of JBJS editorial staff.

    * = Required Field
    (if multiple authors, separate names by comma)
    Example: John Doe





    Related Content
    The Journal of Bone & Joint Surgery
    JBJS Case Connector
    Topic Collections
    Related Audio and Videos
    Clinical Trials
    Readers of This Also Read...
    JBJS Jobs
    02/28/2014
    District of Columbia (DC) - Children's National Medical Center
    12/31/2013
    S. Carolina - Department of Orthopaedic Surgery Medical Univerity of South Carlonina
    12/04/2013
    New York - Icahn School of Medicine at Mount Sinai
    04/02/2014
    W. Virginia - Charleston Area Medical Center